Carpal Tunnel

When the protective covering surrounding the nerves in your hand, arm, or elbow tightens, and squeezes the nerve itself, a condition called hand nerve entrapment can result. Hand and elbow nerve entrapment conditions we treat include:

Carpal Tunnel Syndrome

The carpal tunnel is a space in the wrist where a nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome is a type of hand nerve entrapment that occurs when swelling in the tunnel compresses the median nerve. As a result of the pressure on the median nerve, patients with carpal tunnel syndrome may experience symptoms including:

  • Pain in the hand and fingers, including burning, tingling, and numbness
  • Pain in the wrist or hand, extending to the elbow
  • Sensation that the hand is swollen, even if it is not
  • Weakened grip and difficulty picking up small items
  • Problems with fine finger movements in one or both hands

This condition is common in people who perform repetitive wrist and hand motions, such as typing on a computer keyboard. It also affects those who grip tightly or uses their wrists consistently, such as cashiers, cyclists, meat cutters, and musicians.

Carpal Tunnel Syndrome Diagnosis

The orthopedic surgeons at MedStar Georgetown are experts at diagnosing carpal tunnel syndrome.  Our initial exam serves to rule out other possible causes of your pain and determine the best treatment options.  Our team will generally:

  • Take your medical history – This includes asking questions about when your pain began and when the pain feels most severe. Other questions may be about whether you have other medical problems, and if you take any medications.
  • Perform a physical exam – The orthopedist will carefully examine your hand and press into the affected nerve to test your response.
  • Perform electrophysiological tests – The orthopedist can confirm a diagnosis by sending small electric shocks into the affected area to see how the nerve responds.
  • Perform imaging tests – In some cases, the orthopedist may want to examine the bones in your wrist more carefully using an X-ray.

Carpal Tunnel Treatment

Many nonsurgical courses of treatment for carpal tunnel syndrome are available, such as

  • Splints or braces to immobilize and rest the wrist
  • Adjustments to how you perform daily activities
  • Oral anti-inflammatory medications
  • Steroid injections

If nonsurgical treatment is not successful or treatment is sought too late, surgery may be required. This surgery involves enlarging the carpal tunnel, which will relieve the swelling and pressure on the nerve.

Learn more about MedStar Georgetown's approach to minimally invasive nerve surgery.

cubital tunnel

Cubital Tunnel Syndrome

The cubital tunnel is a narrow tube of tissue at your elbow that contains the ulnar nerve. The ulnar nerve runs from your shoulder down to your wrist and controls movement in your ring and pinky fingers. Cubital Tunnel Syndrome is a type of hand nerve entrapment that forms when this tunnel swells, putting pressure on the ulnar nerve, causing pain and numbness in the hand and fingers.

Cubital tunnel syndrome can cause the following symptoms:

  • Tingling in the ring and pinky fingers, making it more difficult to use them
  • Numbness in the ring and pinky fingers
  • Weakness in the hands

The cubital tunnel is more likely to swell if

  • You sleep or lean on your elbow for too long
  • You bend the elbow back and forth repeatedly
  • Fluid builds up in the elbow
  • You hit or fall on the elbow with force

Other conditions that can contribute to the development of cubital tunnel syndrome include elbow arthritis, fractures, cysts, and bone spurs.

Cubital Tunnel Syndrome Diagnosis

The orthopedic surgeons at Georgetown are experts at diagnosing carpal tunnel syndrome.  Our initial exam serves to determine the exact cause of your symptoms. Our team will generally:

  • Take your medical history – This includes asking questions about what kind of pain you feel and when it began. Other questions may be about whether you have other medical problems, and if you take any medications.
  • Perform a physical exam – The orthopedist will carefully examine your elbow and hand, press into the affected nerve to test your response, and check the strength in your hand.
  • Perform a nerve conduction test – In this test, your orthopedist checks how long it takes for your nerve to respond to stimulation. This helps determine the extent and location of the nerve compression.
  • Perform imaging tests – In some cases, the orthopedist may want to examine the elbow bones using an X-ray to determine the underlying cause of your nerve compression.

Cubital Tunnel Syndrome Treatment

Treatment for cubital tunnel syndrome depends on how severely your nerve is compressed and whether you are beginning to develop muscle weakness. Nonsurgical treatment options may include

  • Braces
  • Splints
  • Injections of steroids or anti-inflammatory medications
  • Physical therapy

If nonsurgical treatment does not relieve your symptoms, or your muscles are weakening too much, you may need surgery. Surgical options can relieve symptoms by:

  • Widening the cubital tunnel to release the pressure on your nerve
  • Moving the nerve so it is more protected from injury

Learn more about MedStar Georgetown’s approach to minimally invasive nerve surgery.

Make an Appointment

For more information or to schedule an appointment with a hand and wrist specialist, call our scheduling line. 

Phone: 855-546-0858

Hand and Wrist Specialist

Michael Kessler, MD
Michael Kessler, MD
Curtis M. Henn, MD
Curtis M. Henn, MD

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